Song Zhi-fang, Yu Kang-long, Shan Hong-wei, Ma Jun
Department of Medical Intensive Care Unit, Xinhua Hospital, The Second Medical University of Shanghai, Shanghai 200092, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2003 Jun;15(6):358-61.
To evaluate the clinical value of mechanical ventilation for patients with acute respiratory distress syndrome(ARDS) as a result of interstitial pneumonia after renal transplantation in the intensive care unit (ICU).
All the clinical data (totally 16 cases) were collected, including the improvement of hypoxemia before and after mechanical ventilation.
Different levels of positive end-expiratory pressure (PEEP) 4-15 cm H2O (1 cm H2O=0.098 kPa) were applied in the patients in whom mechanical ventilation was instituted. The time for different mechanical ventilation was different [1-87 days, (15.4+/-21.1) days] and duration of survival was different [1-1 945 days, (154.4+/-497.1) days]. Only one of them was survived (6.7%), and the others died (93.3%). The causes of death were analyzed. Among the patients who received the mechanical ventilation, 3 patients were alive less than 3 days and their dire ct cause of death was not respiratory (circulation and central). Only one of them did not receive artificial ventilation and the cause of death was hypoxemia. The successful experience for one survivor among the patients who received the ventilator was that hypoxemia was improved by the mechanical ventilation, winning the time for the treatment of the original disease.
The major value of mechanical ventilation was to correct the hypoxemia in order to win the time to cure the interstitial pneumonia and ARDS. The survival rate was still low for such a group of patients because the pathogenesis was not identified, and therefore the disease could not be controlled, even the mechanical ventilation is instituted in time.
评估重症监护病房（ICU）中肾移植术后因间质性肺炎导致急性呼吸窘迫综合征（ARDS）患者机械通气的临床价值。
收集全部临床资料（共16例），包括机械通气前后低氧血症的改善情况。
对接受机械通气的患者应用不同水平的呼气末正压（PEEP）4 - 15 cm H₂O（1 cm H₂O = 0.098 kPa）。不同患者机械通气时间不同[1 - 87天，（15.4 ± 21.1）天]，生存时间也不同[1 - 1945天，（154.4 ± 497.1）天]。其中仅1例存活（6.7%），其余死亡（93.3%）。分析死亡原因。在接受机械通气的患者中，3例存活时间不足3天，其直接死亡原因并非呼吸方面（循环和中枢方面）。仅1例未接受人工通气，死亡原因是低氧血症。接受呼吸机治疗的患者中1例幸存者的成功经验是机械通气改善了低氧血症，为治疗原发病赢得了时间。
机械通气的主要价值在于纠正低氧血症，以赢得治疗间质性肺炎和ARDS的时间。这类患者的生存率仍然较低，因为发病机制未明确，所以疾病无法得到控制，即便及时进行了机械通气。
